Tan Selene Y L, Chai Jia Xin, Choi Minwoo, Javaid Umair, Tan Brenda Pei Yi, Chow Belinda Si Ying, Abdullah Hairil Rizal
Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
Nervotec, Singapore, Singapore.
JMIR Form Res. 2025 Jun 6;9:e60455. doi: 10.2196/60455.
BACKGROUND: Blood pressure (BP) and hemoglobin concentration measurements are essential components of preoperative anesthetic evaluation. Remote photoplethysmography (rPPG) is an emerging technology that may be used to measure BP and hemoglobin concentration noninvasively with just a consumer-grade smartphone, replacing traditional in-person measurements. However, there is limited data regarding the use of this technology in patients with diverse skin tones and medical comorbidities. Hence, widespread applicability is yet to be achieved. The potential benefits of achieving this would be immense, allowing for greater convenience, accessibility, and reduction in labor and resources. OBJECTIVE: Our study aims to be the first to develop an algorithm for noninvasive rPPG-based BP and hemoglobin concentration measurement that can be used for preoperative evaluation of patients in real-world clinical practice settings. METHODS: We conducted the study at Singapore General Hospital from March 1, 2023, to June 28, 2024. A total of 200 patients were recruited. Our primary analysis compared the accuracy of rPPG-based systolic and diastolic BP measurements against measurements taken with automated BP measuring devices. Our secondary analysis compared the accuracy of rPPG-based hemoglobin concentration measurement against traditional blood sampling. RESULTS: Our model performed best with diastolic BP predictions, with a mean absolute percentage error of 7.52% and a mean difference of 0.16 mm Hg (SD 3.22 mm Hg) between reference and measured readings. The 95% CI for the mean difference between predicted and measured diastolic BP was ±0.57 (-0.41 to 0.73) mm Hg. Systolic BP predictions yielded a mean absolute percentage error of 9.52% and a mean difference of 2.69 mm Hg (SD 7.86 mm Hg). The 95% CI for the mean difference between predicted and measured systolic BP was ±1.14 (-1.54 to -3.83) mm Hg. Hemoglobin concentration predictions had a mean absolute percentage error of 8.52%, with a mean difference of 0.23 g/dL (SD 0.67 g/dL). The 95% CI for the mean difference between predicted and reference measured hemoglobin concentration was ±0.10 (95% CI 0.13-0.33) g/dL. CONCLUSIONS: Noninvasive rPPG-based measurement of BP and hemoglobin concentration at the preoperative evaluation setting has great potential for improving convenience, improving efficiency, and conserving resources for patients and health care providers. Our model was able to accurately predict diastolic BP in patients with diverse skin tones and medical comorbidities. The findings of this study serve as a basis for further studies to develop and validate the model for noninvasive rPPG-based BP and hemoglobin concentration measurement.
背景:血压(BP)和血红蛋白浓度测量是术前麻醉评估的重要组成部分。远程光电容积脉搏波描记法(rPPG)是一项新兴技术,仅使用消费级智能手机即可无创测量血压和血红蛋白浓度,从而取代传统的现场测量。然而,关于该技术在不同肤色和合并症患者中的应用数据有限。因此,其广泛适用性尚未实现。实现这一点的潜在益处将是巨大的,可带来更大的便利性、可及性,并减少劳动力和资源。 目的:我们的研究旨在率先开发一种基于无创rPPG的血压和血红蛋白浓度测量算法,可用于现实临床实践环境中患者的术前评估。 方法:我们于2023年3月1日至2024年6月28日在新加坡总医院进行了这项研究。共招募了200名患者。我们的主要分析比较了基于rPPG的收缩压和舒张压测量与自动血压测量设备测量结果的准确性。我们的次要分析比较了基于rPPG的血红蛋白浓度测量与传统血液采样结果的准确性。 结果:我们的模型在舒张压预测方面表现最佳,平均绝对百分比误差为7.52%,参考读数与测量读数之间的平均差值为0.16 mmHg(标准差3.22 mmHg)。预测舒张压与测量舒张压之间平均差值的95%置信区间为±0.57(-0.41至0.73)mmHg。收缩压预测的平均绝对百分比误差为9.52%,平均差值为2.69 mmHg(标准差7.86 mmHg)。预测收缩压与测量收缩压之间平均差值的95%置信区间为±1.14(-1.54至-3.83)mmHg。血红蛋白浓度预测的平均绝对百分比误差为8.52%,平均差值为0.23 g/dL(标准差0.67 g/dL)。预测血红蛋白浓度与参考测量血红蛋白浓度之间平均差值的95%置信区间为±0.10(95%置信区间0.13 - 0.33)g/dL。 结论:在术前评估环境中基于无创rPPG测量血压和血红蛋白浓度,对于提高患者和医疗服务提供者的便利性、效率以及节约资源具有巨大潜力。我们的模型能够准确预测不同肤色和合并症患者的舒张压。本研究结果为进一步研究开发和验证基于无创rPPG的血压和血红蛋白浓度测量模型奠定了基础。
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